Provider Demographics
NPI:1235601758
Name:BEATTY, JAMIE (LPCC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BEATTY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 BENTLEY STATION PL
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-5263
Mailing Address - Country:US
Mailing Address - Phone:614-323-3650
Mailing Address - Fax:
Practice Address - Street 1:1925 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2733
Practice Address - Country:US
Practice Address - Phone:614-754-8051
Practice Address - Fax:614-319-6123
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional